摘要
目的:比较两种强脉冲光装置PhotoDerm和Quantum SR在治疗面部毛细血管扩张的疗效和不良反应等方面的差别。方法:总结2002-01/2004-12卫生部北京医院整形外科所有使用PhotoDerm(P组)和Quantum SR(Q组)治疗的面部毛细血管扩张病例81例,男12例,女69例,皮肤类型为Ⅲ～Ⅴ型。应用Photo Derm治疗者35例,为Phot Derm组,均为局部治疗(面颊及鼻区);应用Quantum SR治疗者46例,为QuantumSR组,均为全面部治疗。Photo Derm,以色列ESC公司,分3种操作界面VL、PL、HR分别用于血管性疾病、色素性疾病、脱毛治疗;波长:515,550,570,590,615,645,755nm;脉宽:1～25ms;能量密度:10～90J/cm2;光斑大小:8mm×15mm、8mm×35mm,无皮肤冷却系统。Quantum SR,美国科医人公司,有560,640nm滤光头,脉宽和脉冲数均可调整,有皮肤冷却系统。治疗后对比前后照片,结合患者满意度判定疗效(优:扩张毛细血管基本消退>75%,无色沉,十分满意。良:扩张毛细血管大部分消退>50%,面部发红明显改善,较满意。一般:扩张毛细血管部分消退,面部发红改善>25%,患者自感有效但不太满意。无效:改变不明显0～25%,不满意。)判定治疗热损伤程度(轻微:轻度灼热感及红肿;中度:灼热感强及红肿明显、无或有轻微散在结痂、无水泡及色素改变。严重:疼痛、红肿明显,数日后消退,有条状结痂、水泡或色素改变。)比较两组治疗疗效及皮肤热损伤反应的发生情况。结果:两组患者共81例全部进入结果分析。①治疗后改善程度:治疗后两组患者均有疗效,其中疗效评价优的共17例,良46例,一般18例。PhotoDerm组中疗效评价优的共5例,良22例,一般8例;Quantum SR组中疗效评价优的共12例,良24例,一般10例;两组比较差异无显著性意义(P>0.05)。②治疗后皮肤热损伤反应:PhotoDerm组轻微损伤7例,中度19例,严重9例,Quantum SR治疗组轻微损伤30例,中度11例,严重5例,两组热损伤反应对比差异有显著性意义(P<0.05)。结论:两种强脉冲光装置在治疗面部毛细血管扩张方面均有很好的疗效;QuantumSR在治疗的舒适性、安全性上优于PhotoDerm;两种强脉冲光装置结合使用可能有助于提高疗效,降低并发症。
AIM： To compare the difference of efficacy and side effects between PhotoDerm and Quantum SR for facial telangiectasia. METHODS： A total of 81 patients with facial telangiectasia were enrolled from the Department of Plastic Surgery in Beijing Hospital, State Ministry of Health between January 2002 and December 2004, including 12 males and 69 females. They were treated with intense pulsed light devices PhotoDerm （P group） or Quantum （Q group）. P group （n =35）： cheeks and nasal area treated with PhotoDerm, which was produced by Israel ESC Company, in operational interfaces of VL, PL, HR for the treatment of vascular disease, pigment disease and depilation therapy; wave length： 515, 550, 570, 590, 615, 645, 755 nm; pulse width： 1-25 ms; energy density： 10-90 J/cm^2; spot size： 8 mm×15 mm, 8 mm×35 mm, without skin cooling system. Q group （n =46）： complete facial area treated with Quantum, which was produced by American Lumenis Company, including filtration sources of 560, 640 nm and skin cooling system; pulse width and pulse number were adjusted. The therapeutic effect of patients were evaluated through the photographs before and after treatment： excellent： facial telangiectasia extinction 〉 75%, no pigmentation, perfect satisfaction; improved： facial telangiectasia extinction 〉 50%, facial flushing was improved obviously, satisfaction; common： partly extinction of facial telangiectasia, facial flushing improvement 〉 25%, no satisfaction; ineffective： no obvious change （0-25%）, no satisfaction. The degree of burn injury was also determined, mild： mild buming sensation and erythematic; moderate： strong burning sensation and obvious erythematic, no or few crust formation, no water vacuole and pigmentation; severe： pain, erythematic, strip crust formation, water vacuole and pigmentation. All cases of two groups were reviewed to compare the efficacy and burning injury.
RESULTS： All 81 subjects were involved in the result analysis.（1）Improvement： Excellent in 17 cases （5 in P group and 12 in Q group）, improved in 46 cases （22 in P group and 24 in Q group） and common in 18 cases （8 in P group and 10 in Q group）. There was no significant difference between the two groups （P 〉 0.05）.（2）Response to burning injury： In P group, there were 7 mild injury, 19 moderate and 9 severe; In Q group, there were 30 mild injury, 22 moderate and 5 severe. There were significant differences between the two groups （P 〈 0.05）.
CONCLUSION： We obtain the same efficacy using the two intense pulsed light devices for facial telangiectasia, and Quantum SR presents superior comfort and security compared with PhotoDerm. Confederative treatment for facial telangiectasia using the two devices can improve the efficacy and reduce side effects.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第9期1679-1682,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
